Psychiatry Consultation Liaison Service Research

精神病学咨询联络服务(PCLS)在NIH临床中心发挥着重要的综合作用。NIH内科研究计划中有洞察力的临床医生与PCLS互动，这导致了在内科疾病的精神病学和心理社会研究领域的独特研究合作。在美国国立卫生研究院其他研究所/中心参加研究试验的患者-受试者提供了无与伦比的机会来探索特定基因(例如单基因疾病)和特定疗法(例如肝炎中的干扰素α)在精神病学和神经发育中的作用。 PCLS神经心理学咨询于2008年10月启动，目前仍是一项积极的服务，每年进行约250次神经心理评估。这些对医学疾病的神经认知表型的评估中有三分之二是NIMH与其他研究所(如NIAMS、NHGRI、NIAID)合作研究的结果。NHLBI、NINDS和其他。 我们的自杀筛查工具重新验证和在儿科急诊室(华盛顿特区、波士顿、马萨诸塞州和俄亥俄州哥伦布)对患有内科疾病的儿童进行自杀筛查的招募工作即将完成。从单一急诊科地点的可行性研究来看，在106名接受自杀风险筛查的内科患者中，6%的人报告了临床上有明显的自杀意念。此外，96%的患者(n=156)表示，护士应该在儿科急诊科筛查儿童的自杀风险。对自杀筛查工具的医疗记录数据的评估发现，在因精神原因到急诊科就诊的12岁以下儿童中，53%的人筛查出自杀风险呈阳性。 与心理健康和儿科肿瘤学临床医生的合作导致了关于儿科肿瘤学护理的精神和心理社会方面的强有力的研究计划的发展，最终产生了一本关于儿科肿瘤学护理的心理和精神病学方面的手册。研究慢性病青年的几项方案正处于数据收集阶段，包括评估儿科疾病人群中的“痛苦体温计”，确定“孤独”父母的特征，以及一项关于其子女即将开始研究的国际家庭的经验和需求的新方案。在成人肿瘤学方面，PCLS的研究人员与一个多学科工作组合作，在临床试验中重新定义了肿瘤学中精神事件的分类。 由临床主任办公室人类受试者保护(HSPU)的临床研究倡导者(CRA)制作的知情同意培训视频将用于NIH所有研究生医学教育临床培训计划的培训。研究评估机构继续提供培训课程，并出席国家会议，介绍它们在实施评估和保护研究中易受伤害对象的标准化进程方面的经验。 由国家过敏和传染病研究所(NIAID)和哥伦比亚特区卫生部(DOH)带头的一项令人兴奋的新倡议是华盛顿特区艾滋病毒/艾滋病进展伙伴关系(DC PFAP)。DC PFAP旨在提高专科护理的可用性，并提供获取循证临床方案和内部研究方案的途径。NIMH PCLS团队是这一重要计划的早期合作伙伴。NIMH将与哥伦比亚特区政府、当地学术机构、当地社区提供者和艾滋病毒/艾滋病患者合作，帮助扩大对艾滋病毒/艾滋病精神和行为方面的知识，特别是在哥伦比亚特区，并帮助确定最有效的战略，以减少哥伦比亚特区艾滋病毒/艾滋病精神发病率的影响。 PCLS研究在过去的一年里取得了丰硕的成果，有超过25张海报、演示文稿或课程，以及下面列出的大量出版物。

The Psychiatric Consultation Liaison Service (PCLS) serves an important integrative function in the NIH Clinical Center. Perceptive clinicians in the NIH intramural research program interact with the PCLS which leads to unique research collaborations in the areas of psychiatric and psychosocial research in the medically ill. Patient-subjects enrolled in research trials in other Institutes/Centers at the NIH offer unparalleled opportunities to explore the roles of specific genes (e.g., monogenic diseases) and specific therapies (e.g., interferon alpha in hepatitis) in psychiatry and neurodevelopment. PCLS Neuropsychology Consultations, initiated in October, 2008, continue to be an active service, performing about 250 neuropsychological evaluations per year. Two-thirds of these evaluations for neurocognitive phenotyping of medical disorders have been as a result of research collaborations between NIMH and other Institutes such as NIAMS, NHGRI, NIAID. NHLBI, NINDS and others. Recruitment for our suicide screen tool revalidation and suicide screening of medically ill children in a pediatric emergency room (Washington, D.C., Boston, Massachusetts, and Columbus, Ohio) is nearly completed. From a feasibility study of a single emergency department site, 6% of the 106 medical patients who were screened for suicide risk reported clinically significant suicidal ideation. In addition, 96% of the total patients (n = 156) stated that nurses should screen children for suicide risk in the pediatric emergency department. An evaluation of medical record data of a suicide screening tool found that 53% of children under the age of 12 presenting to the emergency department for psychiatric reasons screened positive for suicide risk. Collaboration with mental health and pediatric oncology clinicians has led to the development of a robust research program on psychiatric and psychosocial aspects of pediatric oncology care, culminating in the production of a handbook on psychological and psychiatric aspects of pediatric oncology care. Several protocols studying chronically ill youth are in data-collection phase, including evaluation of a "distress thermometer" in pediatric medically ill populations, characterization of "lone" parenting, and a new protocol on the experiences and needs of international families whose children are in research that is about to begin. In adult oncology, PCLS researchers worked with a multidisciplinary workgroup to redefine the classification of psychiatric events in oncology in clinical trials. An informed consent training video produced by the Clinical Research Advocates (CRAs) of the Human Subjects Protections (HSPU), in the Office of the Clinical Director, will be used for training in all the Graduate Medical Education clinical training programs at the NIH. The CRAs continues to provide training courses as well as present at national meetings on their experiences regarding implementing processes to standardize the evaluation and protection of vulnerable subjects in research. An exciting new NIH initiative spearheaded by the National Institute of Allergy and Infectious Diseases (NIAID) and the D.C. Department of Health (DOH) is the D.C. Partnership for HIV/AIDS Progress (DC PFAP). DC PFAP is designed to both enhance the availability of subspecialty care and to provide access to evidence-based clinical protocols and intramural research protocols. The NIMH PCLS team is an early partner in this important initiative. In conjuction with the D.C. government, local academic institutions, local community providers and HIV/AIDS patients, NIMH will assist in expanding knowledge on psychiatric and behavioral aspects of HIV/AIDS, specifically in D.C., and help to identify the most effective strategies for reducing the impact of psychiatric morbidity of HIV/AIDS in D.C. PCLS research has had a productive year with more than 25 posters, presentations or courses in the past year and the numerous publications listed below.